Imaging continues to assume an increasingly important role in the assessment of patients with rheumatoid arthritis. Application of MRI and Doppler ultrasound to this group of patients has revealed important insights into disease processes in rheumatoid arthritis, identifying previously concealed processes that cannot be viewed with conventional imaging. These processes include osteitis, synovitis and early bone erosion. Together, these imaging techniques provide methods for assessment of treatment response as well as short- and long-term outcome. This article examines the current state of imaging in rheumatoid arthritis, with an emphasis on assessment of treatment outcome.